Switching to New Doctor Delays Breast Cancer Treatment

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People newly diagnosed with non-metastatic breast cancer who switched their care to a different doctor had various treatments delayed by more than a week, according to a study.

While the delays didn’t affect survival, they did increase the risk that the treatment facility would not meet national quality standards for timely treatment.

The research was published in the February 2019 issue of Breast Cancer Research and Treatment. Read the abstract of “Treatment delays from transfer of care and their impact on breast cancer quality measures.”

Why timely treatment is important

Doctors recommend starting treatment as soon as possible after breast cancer is diagnosed. Timely treatment reduces the risk that the cancer will spread and increases the chances for survival. Still, you do have time to do research about your unique situation and ask for a second opinion, if you would like one.

But it is important to know that research has found that delaying surgery for too long — more than 6 weeks after diagnosis — can affect survival for some women, especially younger women.

How this study was done

To do the study, the researchers looked at information on 622,793 people newly diagnosed with non-metastatic breast cancer between 2006 and 2015. The information came from the National Cancer Database, a collection of data from more than 1,500 Commission on Cancer-accredited facilities. The database is sponsored by the American College of Surgeons and the American Cancer Society.

The researchers found that 36.6% of the people in the study transferred their care to a different doctor after diagnosis.

For the people who switched to a new doctor:

  • Surgery was delayed by 7.3 days.
  • The start of chemotherapy was delayed by 7.8 days.
  • The start of radiation therapy was delayed by 8.7 days.
  • The start of hormonal therapy was delayed by 9.8 days.

"These findings are important, but not clinically significant," the researchers wrote. "There is a delay in treatment when patients transfer their care, but it is not enough to impact clinical outcomes."

Still, the researchers pointed out that people who switched their care had a 76.6% higher likelihood that breast cancer surgery would take place more than 90 days after diagnosis. While there are no national guidelines for when surgery should happen after a breast cancer diagnosis, more than 98% of breast cancer surgeries in the United States happen within 90 days after diagnosis.

Switching to a new doctor also was linked to a higher risk of chemotherapy, radiation therapy, and hormonal therapy failing to meet recommended guidelines for timely treatment.

What this means for you

If you’ve been diagnosed with breast cancer, it makes sense to take the time to do some research to make sure your diagnosis is correct and your treatment plan makes sense. There is definitely time to get a second opinion or transfer your care to a different doctor, if that’s what you decide to do. Still, it also makes sense to start treatment as soon as you feel comfortable with your doctor and your treatment plan.

If you don’t have insurance or are unemployed, you may be considering delaying your treatment because you’re worried about how you’ll pay for it. Don’t panic, and don’t skip any doctor’s visits or delay your surgery. Your life may depend on it. There are resources available to help you.

Someone at your doctor’s office may be able to give you a list of organizations that offer financial assistance for breast cancer treatments and care, as well as local organizations that offer financial assistance for your practical needs, such as transportation, food, and child care.

Also, many hospitals now include patient navigators as part of the breast cancer care team. A patient navigator can help you understand and move through the healthcare and insurance systems. Patient navigators also can help overcome language and cultural barriers, as well as any biases based on culture, race, or age. Ask your doctor or nurse for a patient navigator recommendation.

There is only one of you, and you deserve the best care possible, given in a timely manner. Don’t let any obstacles get in the way of your treatment!

For more information on how you can get financial help, visit the Breastcancer.org Paying for Your Care pages.

Written by: Jamie DePolo, senior editor

Reviewed by: Brian Wojciechowski, M.D., medical adviser


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